Organization Active NPI

City of Lake Crystal

Doing business as Lake Crystal Ambulance Service

  • Land Ambulance
  • Lake Crystal, MN
National Provider Identifier
1679584205
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0127 Issued in MN
Legal business name
CITY OF LAKE CRYSTAL
Doing business as
Lake Crystal Ambulance Service
Practice address
181 S Hunt Street
Lake Crystal, MN 56055-0086
Phone
(507) 726-2538
Fax
(507) 726-2265
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rhonda Truman-Ingebritson
Title
Ambulance Director
Phone
(507) 995-6205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0127 MN Primary

Addresses

Primary practice location

181 S Hunt Street
Lake Crystal, MN 56055-0086

Mailing address

100 East Robinson Street
P.O. Box 86
Lake Crystal, MN 56055-0086
Phone (507) 726-2538

Other identifiers 2

IdentifierTypeStateIssuer
590095208OtherRAILROAD MEDICARE
181767100MedicaidMN

Other names 1

  • Lake Crystal Ambulance Service Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120213000068 MN Part B Supplier - Ambulance Service Supplier 5092972588 Practice locations: Lake Crystal, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0959632Lake Crystal Ambulance181 South Hunt Street, Lake Crystal, MN 56055Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1679584205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAST ROBINSON STREET",
            "address_2": "P.O. BOX 86",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "560550086",
            "telephone_number": "507-726-2538",
            "fax_number": "507-726-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 S HUNT STREET",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "560550086",
            "telephone_number": "507-726-2538",
            "fax_number": "507-726-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF LAKE CRYSTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "TRUMAN-INGEBRITSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "AMBULANCE DIRECTOR",
        "authorized_official_telephone_number": "507-995-6205"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MN",
            "license": "0127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590095208",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181767100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Crystal Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.